By Christian Regalado
If this title got your attention, I highly recommend you read each of these tips below. Your medical care coverage is extremely important to understand in order to both save you money and take care of your health. Here are 6 important tips:
Know Your Coverage:
This sounds basic, but it can be tricky. This is because Medicare is divided into several parts: Part A covers hospital stays, Part B covers medical services, Part C combines Parts A and B (known as Medicare Advantage), and Part D provides prescription drug coverage. Supplement plans are an alternative to Part C for a higher premium. They are widely accepted and will cover many or most of the out-of-pocket costs when using Parts A and B. If you chose an Advantage Plan, be sure to keep track of the services and treatments covered under your plan to ensure you make the most of your benefits. This is easy to do, you just may need to learn how. We are here to help.
Know Your Costs:
Medicare Part A has no premium. The Part B premium just increased to $202.90 for 2026. If you buy a supplement plan, you pay an extra premium to know that when you need coverage, you will have many options for care and low out-of-pocket expenses. However, you are paying a guaranteed $1.5k-$3.5K extra each year in premiums for this peace of mind. You will also need to add a Prescription Drug Plan, which can be an additional premium. However, another major advantage is that you don’t have to worry about an insurance carrier denying a claim. You are still on Original Medicare with the government, and they are not known to deny claims from your doctor.
Those who choose an Advantage plan may have $0 or low premiums, but need to understand their deductibles, copayments, coinsurance, and of course, max out-of-pocket expenses. Many HMO and PPO plans have become available that will give back a portion of the Part B premium. These are known as “Giveback Plans” This can result in some significant savings.
Know Your Network:
I honestly can’t emphasize this part enough. When it comes to Advantage plans, don’t be fooled into switching plans without first reviewing the network of care providers. Knowing which doctors, specialists, hospitals, and pharmacies are in-network can significantly impact your out-of-pocket expenses, as well as how often you will use their services. If you decide to change Medicare Advantage plans, be sure you are comfortable with the network of providers that will be covered under your new plan. Most providers accept Original Medicare. If you decide on a Supplement Plan, you just need to make sure the provider accepts Medicare.
Know the Benefits:
Each Medicare plan offers different benefits beyond basic coverage. Some plans(Medicare Advantage) include additional perks like dental, vision, hearing, fitness programs, and even transportation services. Understanding these extra benefits can significantly enhance your overall healthcare experience. For instance, Part B Giveback, OTC Allowance, and access to specific wellness programs or health services tailored to the community are all extra perks worth knowing about. Take advantage of these offerings to optimize your Medicare plan.
Know Your Enrollment Dates and Your Local Independent Broker:
Knowing both of these is honestly very important. The Annual Enrollment Period for changing PDPs and Medicare Advantage plans is October 15th to December 7th each year. The Open Enrollment Period for Medicare Advantage is January 1st through March 31st each year. If you missed AEP or want to change your Medicare Advantage Plan for any reason, you can do a one-time change during this period.
A knowledgeable independent broker can provide personalized guidance, answer your questions, and help you explore various Medicare options available specifically to the area. We understand the local healthcare landscape and can assist in finding a plan that aligns with your unique needs and preferences. Whenever you have a question about your coverage, you know exactly who to call and don’t have to worry about some random operator giving you biased or inaccurate information. We are not bound to any specific carrier and can therefore educate you on most/if not all of your options. Plus, since brokers are commission-based, this is a no-cost service for you.
I hope you learned something here, but I’m sure you still have plenty of questions. Not to worry, we are just a phone call or email away to help. Reach out anytime! Email Christian@evergreenhealthins.com or call (850) 687 7606.
